HomeMy WebLinkAbout2283 WATERMAN WAY - Building Permits " 6
pST/ CITY OF COSTA MESA
BUILDING DIVISION
- •j •.,.. : , DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
�. " �ti PERMIT
"�orts
uo�'�`• BOS-00447
*-
(714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
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Job Address: 2283 WATERMAN WY Status: ISSUED
Suite: Applied: 03/18/2005
Vicinity: Issued: 03/18/2005
Primary Occ: R3 Type of Construction: 1
Parcel Number: 42604162 Zoning:
Applicant: RAFAEL LEMUS ISSUED BY: /
Address: 2016 WALLACE AV
UNIT B Phone: 949-642-7057
COSTA MESA,CA Zip: 92627
Owner: HUGHES, GREGORY K
Address 2283 WATERMAN WAY
Phone: 949-548-8681
COSTA MESA,CA • Zip: 92627
Contractor LEMUS ROOFING
Address: 2016 WALLACE AV
UNIT B Phone: 949-642-7057
COSTA MESA,CA
Zip: 92627 " License: 826813
Arch : - - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF WOOD SHINGLES INSTALL 1/2"CDX AND 30 YEAR COMP. SHINGLES.WITH 1 LAYER OF 30 LB FELT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $7,000.00
Permit: $139.25 • Claim Valuation: $7,000.00
SMIP Res: $0.70
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.95 •
•
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right OL 0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(8/00)
OECeARAT/ONS
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WORKERS'COMPENSATION DECLARATION: V •
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to sell-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
elik for h rmit is
I
have
whicwin maintainthispeworkers'issued.compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
o comp`ensatl�n I"nsuran rrier and policy number are: ` @ �7
vier S-4-3 -e, YU\ Policy.Number: !78 / ZJ C
section need not be completed if rhe permit is valued arm one hundred dollars($100)or less.)
❑ 1 certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation :lifomla,a . agree that If I sho d become subject to the workers'compensatlo s of Section 3700 of the Labor Code,I shall forthwith
co r• , . .
Appfi I_ ./ J. .J/IU Date''� 3-16-d S
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION At ERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYEWTTO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DC:C ARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereb .• a am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,aannd,my license is in full
— / Class-th C— -3°7 C f l C
3 — LS-c'S
CONSTRUCTION LENDING AGENCY:
•
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If.however,the building or improvement is
sold within one year of completion.the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business end Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Gm 2,Art 2.Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons.
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas al standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safely Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
_
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(if yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Cale Section 42303 been made? 0 Yes ❑No
8 (If yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the Information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Wehei Signet re Of Legal Owner(s) Date
7, a 5 •
And/Or Author`` dapplicar� Dale
cogL4 INSPECTION TYPE PAIL MALI CODEI INSPECTION TYPE PAIL INTII1AL9
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final s.� 208 Final Plumbing
200 Final Re-Roof G"4f.42/ 64-141 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
C l� / --
C !,
IC- 5,' INTERNATIONAL TESTING CORPORATION
_L_.
x 6173 Cherry Ave Long Beach, Cala — long Beach GA 24550 - GA 2-7500 • NE 6.7821
f 1670 Bahcocl A•enue -vs •P.n.4 Pae! Coale Mein MI 64826 K1 5-8888
T 3552 Buena Vista Awe, Lemon Grove, Calif. — Lemon Grove HO 3.7751
REPORT ON tLdViI SPECIMEN TESTS
GUNITh
Identification No. : P-363-574- 585-
Client : C. E. Moseley
Architect or Engineer : Campbell-Miller
Contractor : K & R Construction, Phillips it Williams Gunite
Structure : Swimming Pool-2283 Waterman Wsy , Costa Mesa
(Terry La Crusha)
Sample From: West Wall at Love Seat
Nix : 1 - 4% P.S. I. 3,000
Total Water:
Field Nos . :
Age : 7 Days I9 Days 28 Days
Specimen Nos . : TC-GI TC-G2
Date Made : 10-31-63 10-31-63
Date Tested : 11-7-63 11---28-63
Average Size : 5.50 x 12 5.75 x 12
Area , So. In. 23 . 74 25.97
COMPRESSION ---
Total Load, Lbs. 21,500 60,250
/
Lbs . Per Sc . Inch: 910 ^ - 2,320 1,7
Specimens Made By : Bob Burton Nozelman
Specimens Delivered By: International Testing Corporation
Specimens Received : 11-2-63
cc: C. E. Moseley (4) - *Ac
I
2
Ylei
i��Y P)ERATION
DML:r a/-Ati mm _ape Arse,
ab
This copy to building Dept. •
CARL E. MOSELEY - l0 TTi1 w
3235 Nebraska Pl. p DE4c `(�
Costa Mesa, Calif. 1\ 1
13 November, 1963 tEr 1,01 3'5 1963 e
costa *less
CdB� ngwep4 \�
Mr. Terry Crusha
2283 Waterman Way
Costa Mesa, Calif. S
RE: Test specimen failure,
Dear Terry:
The attached test report indicates a complete failure in your gunite
test specimens.
The question comes to my mind how and when the specimens were moved
from the floor of the pool and relocated in the front of your
home where I picked them up for the Laboratory. If these specimens
were moved shortly after they were made and I left the project
it is possable they were damaged and the failure is the fesult
of the handling.
I am asking that you contact the Laboratory by phone and request
another break of the Hold Specimen at 14 days, this may indicate
only one specimen was damaged in the handling, however should the
second one break low as indicated on the FIRST test, it is quite
evident your handling did damage them; Let Us hope only one was
damaged.
Your disrAbution on the reports are as follows,
The City of Costa Mesa Bldg. Dept. gets 2 copies
Phillips and Williams will receive only 1 copy
You retain a copy for your file.
Yours truly,
/'� Carl D :Mos eyG�
3' t
CITY OF COSTA MESA
CALIFORNIA P.O. BOX 1200
FROM THE OFFICE OF THE PLANNING DEPARTMENT
Mr. Terry L. Crusha August 6, 1964
2233 Watcx n an Way
Costa Mesa, California
Dear Pool Owner:
The Costa Mesa Planning Department has been notified of the completion
of your swimming pool.
So that your pool will be a safe one and for the purpose of advising
you of your responsibility regarding the requirements of the Costa Mesa
Municipal Code, we quote Section 9298.9:
1. No swimming pool shall be constructed closer than five (5)
feet to any property lines, measured from water line of pool.
2. No swimming pool shall be constructed under any electric power
lines or on any electric power easement.
3. No swimming pool shall be constructed unless the yard
surrounding such pool is completely enclosed by a fence
six (6) feet in height and have a self-closing and
locking type gate or gates.
This courtesy letter is directed to you so that you will be aware of
our ordinances and can make a complete safety check of your pool area.
Sincerely yours,. (1
ft
William L. Dunn
Director of Planning
CITY OF COSTA MESA
CALIFORNIA, P.O. BOX 317
Froth the Office of the Planning Department
Regarding Building Permit No. 20766 Date: 2-28-64
Location: 2283 Waterman Way
Dear Pool Owner:
The Costa Mesa Planning Department called at your property to inspect
the Swimming Pool. Our interest in pools is for the purpose of safety
and to be sure all provisions of Section 9298.9 of the Municipal Code
have been met.
Section 9298.9:
1. No swimming pool shall be constructed closer than five (5) feet
to any property line, measured from water line of pool.
2. No swimming pool shall be constructed under any electric power
lines or on any electric power easement.
3. No swimming pool shall be constructed unless the yard surrounding
such pool is completely enclosed by a six (6) foot fence or the
pool itself is enclosed with a fence six (6) feet in height and hav-
ing a self-locking type gate or gates.
Note: (Gate should close and latch on a free swing).
Your pool will not receive final approval until the requirements of the
aforementioned Section of the Municipal Code have been completed.
The following disposition is noted in reference to your pool:
J No one was at home.
pa No springs on gate.
❑ Improper latch or defective hardware.
❑ Wall surrounding pool not 6' high.
❑ Other.
[ Telephone 646-2411 and ask for the Planning Department so
that an appointment may be arranged.
Since you have incurred certain liabilities through the installation of a
pool, it is requested that these matters be taken care of as soon as possible
so that your pool will be a safe one.
Sincerely yours,
By
Planning Technician
Qjtie l-t;t1/4''//- '/4// CGS
ir
• ai�8�.r—a �' 0 OCT 171962
COSTA MESA BUILDING-SAFETY DEPARTMENT E.LiiP "8
P. O. BOX 311 COSTA MESA. CALIFORNIA
/0s7529- FINANCE DEPT.
For Applicant to Fill In Completely APPLICATION,FOR-PERMIT
TYPE OR PRINT bill f VUOIf MESA
_ 7 BUILDING
ADDRESS ryZ Z 73 GJ�F_,p/.y�It 14447-7/0°COSTA MESA. CA11F/O•BR,NIA For Office Use Only OWNER /7 (J/(/JA/)Wy/,/,/ I RECEIPT NO. P 1 CJ01 6
MAIL "^3 3 / '/ ( RECEIVE9 BY DATE/ECE7D DATA ISSUED
ADDRESS //JT'�//�/ 7 L/ ��/ , I f/ ��� U .1 'IA1962 •
CITY e- / // ryE (�/0�z BUILDING L / / /
ADDRESS J
ARCHITECT T�'1'^- '�a`,,{(,,COITA MESA. CALIFORNIA
OP JNEER NO. ' >
FIRE /
ADDRESS / ZONE TYPE GROU
7
CONTRACTOR a/ / I APPROVED
BY DATE
ADDRESS S ZONING
ZONE,/ I NO.OF I USE OF NEw SAI --- A4,
CITY / /� Z PLANSa BUILDING kiln
hi dia.‘•
STATE 7(9 0 9dJ TEL ------
LIC.No. G N NO. LEGAL / 7 r (/ 8 7
SIZE 4//ii 9 N/ 3 X 3P X DESCRIPTION �-e
�
G O 'O NO. OPSLOTS.
OF LOT `/ X _73, // NOW OH LOT (/ A.P.NO.
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK L�/// '/ // (CENTER LINE ST.) [J
CENTER OF LINEFROM
�/ REAR YARD//'7 M'', FRONT I FT. IN.
SIDE YARD I LEFT S 14
'/ I RIGHT 6- /6 " R.SIDE -S FT. /‘ IN.
DESCRIPTION OF WORK L.SIDE u5 FT. /Y IN.
NEW IX. II ALTERATION I II ADDITION I REAR / / FT. IG IN. 9
REPAIR I I MOVING I D DEMOLISH I APBYPROVED C0107/7//
DATE /0//6/6 t
BUILDING /.7/� NO. OF D.-- �
SIZE 460.2.43.7 ROOMS O S ORIES
EXTERIOR WALL(/F I ROOF /6/_
COVERING , /- COVERING (�(!
USE OP,BUILDING AND WORK TO BE�PE�R,F/ Ry/M/SEED _
� d / /'CJ/Y//LT,/J_
t,tr "to ul( - nit `/a an
•
I HEREBY ACKNOWLEDGE THAT I HAVE READ THI PPLICATION THE AMOUNT RH WN UNDER VALUATION IS FOR THE
AND STATE THAT THE AB VE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CIA ANCES ST LAWS REGULATING
BUILDING CONSTR N. VALUATION A
SIGNATURE OFali /(y/,/ ^�J PERMIT FEE $ O(/-�
PERMITTEE $ / 335 PLAN CHECK $ 30 — M
(�
AUTHORIZED AGENT 2 /
TOTAL FEE $ % O O
6
V
•
OWNER CRUSHA, TERRY L. DATE OCT 7 1l3
JOB ADDRESS 2283 Waterman Way BUILDING PERMIT NO. 20766
GENERAL CONTRACTOR Owner-Builder VALUE $ 2,500.00
AP No. 118-202-20 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORKPvt. Swim Pool
$ IDr-nECTIONS Signature DATE GROUP J TYPE III ZONE R1
S PERMITS ISSUED
C Gay SUBCONTRACTOR DATE NUMBER
Water
Rough Com. Rcfrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing,ky,., > :era, Ca-ey-vtae../ /a-7-G3 3 9 re6,4.,
Miscellaneous
Prop. Swr. Line 0 House Con. 0 St. Swr. 0
Sprinkling System
Construction Pole
Underground ❑ Power 0 ///GJb ((r($;65
Rough Wiring ./, •C., , 4 /e, - 7-c 3 a //o-7--
Trenches 40- Forms 0 Steel Reinf. a = "' 2/ .7
V
/I
Floor System 6
Bond Beam 0 Steel Reinforce VI-, 'A-4,1� /p�312--�Cg
Sheathing
Frame and Flashing
Lathing — In f Out ❑
Plaster, brown coat n '
B -1. ❑ Air Con. 0 Final Q..)
I, Ag, Final
Plumbing Fixtures, Final 9�e-- 7,/17
Final Gas Test
Electric Fixtures, Final - ‘� k
Building, Final 2 j �/
OCCUPANCY
Fnrm 13II4-5M-3_63-S-B P Hf1P.D 'WATT PAVr TT. RFYITTTRPMPITTe ofl74
n s207R6 FEE RECEIVED
.
COSTA MESA BUILDING-SAFETY DEPARTMENT OCT 7 1083
P.O.BOX 317 COSTA MESA,CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely CAPPLIWtOST4d403ftwouT
TYPE OR PRINT BUILDING
BUILDING ,7 c,23_6 4N L/ For Office Use Only
ADQRESS T I id
RECEIPT NO. P MIT NO.
COSTA MESA, CALIFORNIA •10 7,4
�J��7 / , I,r�/ RECEIVED BY DATEIRECEIVED _ DATE ISSUED
OWNER 776/P/�C / F". CR VV a- /4— Ac' - 7•-4 /.5-:740--
BUILDING
/5 /`
MAIL - /.2e ! _ aJftr erm,9d 41 ADDRESS i
ADDRESS CLL7JJ��L ✓ /-K
FIRE 11
CO Te �/ J�, TEL ZONE /,F,—/�Cf,.YPE GROUP )1/1CITY V NO•� /�� - APPROVED 1' // // •
ARCHITECT - - TEL. -- In --�Jr�•/Ja��So DATE
OR ENGINEER NQ.
ZONING
A. SS
i ZO f' / NO.OF' OF NEW ^ p I
�(W lite F h ai- 'lc// PLANS (/ BUILDING \\✓-!,
CONTRACTOR /V/ 'Y 'G/ lVY y /+- /,(y/� VW-7 L9 7
LEGAL / ,`/ I 7 ! r` 4 `/ ? /
ADDRESS DESCRIPTION
CITY • A.P.NO. // 8 — 32 — a 0
NOTE: NO EAVE OVERHANG SHALL SE LESS THAN
STATE TEL. - -
90"TO SIDE a REAR P.L.
LIC.NO. .7 ' / " NQ.
EAVES
SIZE
OF LOT � q I NOW O'n Lois / ALLOWED
ARDS APPROVED C
(U YARDSOAPPROVV Y EDREQUIREMENT/
USE
EXISTING BLDG. ,NCS:nI Pr- 4.. ,4{� 9� Y
" C MAIN BUILDING ACESSRBUILDING
/ �� REAR YARD/ (FROM C/LS/TTREET)
SETBACKNTEROP LIE SN TRFE / FRONT •Ct9j.-
FT. I FT.
CEET
SIDE YARD I LEFT '/6r/ I RIGHT G2 / R.SIDE FT. FT.
DESCRIPTION OF WORK L.SIDE 6 FT. - • FT.
NE,'" ALTERATION _ ADDITION REAR 4 FT. FT.
DISTANCE BET. BET.MAIN a
REF-.-..R MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGS.
BUILDING ♦/ NO.OP VAR.3R DATE
SIZE ROOMS `� STORIES C.U.P.# An. APPROVED
EXTERIOR WALL I ROOF APPR
COVERING `-- COVERING BY 1 DATE ��—� V 3
USE OF BUILDING AND WORK TO BE PERFORMED
� j
/ rr iui97`' SW ;M. 4h
a
SQ.FT. O
--1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE T COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CITY ORDINANCES AND STATE LA R TI G VALUATION /) m
SIGMABUILDIG CONSCDOM� PERMIT FEE $ / L2
61GNATURE _// II
PERM ITTEF q•
/ m
S /I�dO PLAN CHECK $ /: 0
AUTHORIZED AGENT 026—d0
/ C/ E
TOTAL FEE 5 a `�